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16135 SW PACIFIC HIGHWAY
-t;JNG CITY
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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONIC 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following itern(s) require correcting.-
Date: ��''- �":� -__ Permit No.
Inspectof''�
q
CALL FOR REINSPECTION
_ ~` 'PLUMBING PERMIT v
holder of a valid plumbing ntractors license is her: Y;
authorized to cause plurrihing work c►s herein noted to be installed t dA- 'th the plumbing coda of
7 i;Inrd. Such installations require inspection by tl City In
'1 ( tc�r � o s. � tified not less than four
(1) hours prior to the time the installs ' are
r for Tigard Business license required
for all contractors and sub-contractors. -
O��nery.Z_.�.�. Job
NUMBER OF TOTAL
TYPE OF PERMIT... Ifth1S �FFI:O.�lll CACH PAOUNT �
Sinate Far.,ily_1 b-ith-eacn ZS
buplax�•Eac,ti 00-
1 bath unit
a
Additional twhrocrns-eeach _ _. _ ._... _.10.00
hlobile Horn!Space-each _ ----�-._ 15.00
IPIbIVIDUA_L-FIXTURE�J
1 to 50_Fixtures in 1 buildi -each 3:00
1 �51 to foo Fixtures in 1 buildingench 2,50
I 101 to 200 Fixtures in 1 buildir�---Each,_--- 2.00
--Z-0-1
_
701 or mo�e_F ixt.1'es in. 1150
1 builr!iny-each_ — ^
11.1 TSC fi l L A N E G U S _..._._......_..._ .._...
I._ ISC E L
Sewo each ar ddirionar 190 ft,
:_�
War$arvire to bui(din2____��__ __..,.. ... _�T 6.00 ry _
~Qthpf
l_PF ftM l7 _ ��� T• Fr•-lu,
4%,State `� Plumbing Contractor By
rOTnt oi,fc+ lr�r Issued ny _�------._.___
K,t.
' tiif Jird f3 Fa; ,42120 ti.lfv. W.--Ori stree, fi arr!, orrigort 4�iE ► !"'{,r,,no 639.417
LUINLI
Porinit NO,
• 4
Expires
i'59llt�f�
t4f!�ir g
1LYGLaloti
Owner1
y�yy
e t• Addlessof
Builder
Address of
it rqs runt~ Prior io the Fc)!Iowln Inspnc:fions'
AVA1'iON OR F=1t,.,t_ N PLUMBING
*°!SCJ 7,1,x.. f ' "ATfNU
lwORCiNG •.TEES. ( LLBOA1
AMiNG F iNA4..
Mf-18t.SO Cosr+',l,ICUOUsly Pasted, Facing ghx.N Street L;Af C onipletlo"
., .,.. ✓1°"V"•,u1'+r'�r,.....,.. .,_.,._....r•Y'Y•'-'`M ri.FoSvrhp" ` ar +...w..�v=-�o...r..+-w .,,,..... •.^,__.., ._. , ,�
BUILDING PERMIT APPLICATION KING CITY DATE----- 19 CA
�
THE/UNDERSIGNED HEREBY APPLIES FOR APERNIIT FOR THE WORK HEREIN INDICATED BUILDER PHONF�'3 �
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING FLANS AND SPECIFICATIONS OWNER PHONE
L
0 X LOT NO..���L�'�Q�l+
OWNER Tualatin LF1U• L0II06ADDRFSS1t=J. ` 21 ►iI. HOME ADDRESS
ARCHITECT
BUII_DER 4 m ADDRVSS1 ,*100 5"; .t l'. th ENGINEER
DESIGNER
STRUCTURE ONEW ❑RI MnDEL G ADDITION ❑REPAIR [:]RENEWAL ❑FIRE DAMAGE [:]DEMOLITION
❑ RESIDENCE OCOMM ❑EDUCATIONAL ❑GOA"T ❑RELIGIOUS❑PATIO ❑CARPORT ❑(34RAGE ❑STOFIAGE❑SLAB ❑FENCE
❑BOND ❑MOV INC ❑CONDITFINAL USE Cl DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
.. -. ZONE-.-" .
r UPANCY LAND USE ZONE —BLDG.TYPE_���_FIRE PLAN CHECK BY ° HEA?-
unstruct single rnmi.ly Uwelling to bb i.ju a(a Homo 'Aleve lil l'icu,
5rE GOMPECTION SHEET ATTACH€D, Co. Hoalth :bapE. -.Tppruvsl rwquize(J toi Isweptlt,
sSystom. Separate plumbing 1 mechanical perml t ii raqui rsde 3 i uture Uadi,,ams p
2 Esathe. -------
QC(:GLOAD __ FLOOR LOAI? �(�—__ HEIGHT 12 NO.STORIE5 •�' ^AAEA 110NO.ffalRQQf�I_S VA UV-9 600.
BUILDING DEPARTMENT SET BACKS FRONT 30 REAR Ll-9 LEFT SIDE 4 RIGHT SIDE 26
Permici'i�•OIJ -v t--3ans t i ur Sac; �Il cF.T"6ius�--
THIS PERMIT IS ISSUED SUB)FCT TO THE REGULATIONS CONTAINED IN THE RUILDING CODE, ZONING
Ian Check 170.50 w REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBV AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIAFIuk C:ITH
Sub-tot1.I "j42! ..a ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF TF!;S PERMIT DOES '40T WAIVE
RESTRICTIVE COVENANTS. CONI HACTOR AND SUB CONTPACTORS TO HAVE CURRENT Cl rY BUSINESS
Stat Tax '.1 E.� LICENSE. SEPARATE PERMIT'; REGUIREC FOR SEWER, PLUMBING AND HEATING.
Total ;'149, 3` _---j
By � �+l
APPLICANT OR AGENT -
Approved �0 Rereihl No
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Q�Q Contractor I
/i`QG �ht J QMw� Permit Ne. OL
����4• KOct � Rough-in
3 'Z7
Pr.) C-L_ Fixture
Final
BEATING
Ife - -
Oontractor
PermitNo NA,M•tr�
Gas or 011
Rough-I1,
Final
S.WER
Final
DRIVEWAY -- —
Final
Scofm Drainage
(Rain Drain)Final
-- — H Sidewalk
--__ Curb&Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY r
CERTIFICATE OCCUPANCY Final
Lendscaping
Zoning Final
.;r
City of Sing City
15390 S.W, 116th avenue
Portland, Oregon
97223
Februa - 21, 1 T'o
r'ualatin Development Co.
15300 S. W, 116th
King City, Oregon 97223
Attns John Adams
Res Tualatin homes Sales Office
lie King Cite Council at its regular stated meetin 20, 10£+0
approved ,your proposed plans for the d.ispla:, office named above at: the
S. W. Pacific Uighwa7- site,
The only conditions imposed are the need ror approval of and connection
to the pre-existing* septic tank sewame disposal and the Orel under-
standing that this sti-tIcture will be so constructed that it can be
moved to a residential site when its use as a commercial office is
terminated.
L, S. Carroll, Mayor
/rw
ccs Ed Walden ✓
- fee 41
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BUILDING SITE REPORT CR: '�1
Washington Countfy De artment of Public Health Date:
TdR���Sec. 1S T.L. 6M _Lot No. BI k. Subdivision—
Street 37,tapmi6�
,,--,Report to: ]'tXik4hil tG b SizA of lot or tract (dimensions)_____
1 n 5300 5cu j Single Dwelling Parceling
Trailer
Commsrctal_�i"� Other
Phone:— t:- 3101 Types of water supply: Private _ Pub I i c ✓
NOTE:. BRING REPORT WHEN APPLY 143 FOR HEALTH DEPARTMENT PERMIT. Plot pian will be
conditional upon issuance of a tax account number or Planning Department approval .
CAUTION: TEST HOLES MUST BACKFILLED AFTER INSPECTION! tt��
OVED jAWW'0� `TjyiyP ED. 5coi
Minim m S1 ewa i Area 1011111M 0. sitod. ��vl�
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cxnments
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Date 2t�--g Bye Public Health Sanitarian
WCOPH S-50 Rev. 3/75 (`i �� /) (OVER)
APP( . I.a cn�GQ 1{ti oin v_4-4 ,'
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